title: Endoscopic injection of glutaraldehyde cross-linked collagen for efferent limb incompetence in the Indiana reservoir.
abstract: OBJECTIVE
  We determined the clinical applicability, safety and efficacy of endoscopically injected glutaraldehyde cross-linked collagen for the treatment of efferent limb incompetence in the incontinent Indiana urinary reservoir.
  
  
  METHODS
  Six patients were diagnosed with incompetence of the efferent limb of the Indiana reservoir by video urodynamics. Glutaraldehyde cross-linked collagen was injected through the efferent limb at the level of the ileocecal valve. Outcome was assessed by evaluation of dryness and pouchograms.
  
  
  RESULTS
  With a mean followup time of 26 months (range 6 to 36) after the last injection 5 of the 6 patients were cured. The remaining patient, although improved, had a small capacity and subsequently underwent ileal patch augmentation. No patient failed to improve. The mean volume of collagen was 16 ml. (range, 5 to 26). Reservoir volume increased from 150 to 400 ml.
  
  
  CONCLUSIONS
  The use of glutaraldehyde cross-linked collagen in the treatment of the incontinent Indiana reservoir is safe and effective.
authors.affiliation: Department of Urology, Lahey Hitchcock Medical Center, Burlington, Massachusetts 01805, USA.
authors.forename: J J
authors.initials: JJ
authors.lastname: Smith
authors.forename: S J
authors.initials: SJ
authors.lastname: Swierzewski
authors.forename: W
authors.initials: W
authors.lastname: Bihrle
authors.forename: M J
authors.initials: MJ
authors.lastname: Malone
authors.forename: J A
authors.initials: JA
authors.lastname: Libertino
mesh_terms: D000328:Adult; D001672:Biocompatible Materials / Q000008:administration & dosage / Q000627:therapeutic use*; D003094:Collagen / Q000008:administration & dosage / Q000627:therapeutic use*; D003432:Cross-Linking Reagents / Q000008:administration & dosage / Q000627:therapeutic use*; D004724:Endoscopy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D014547:Urinary Diversion; D016476:Urinary Reservoirs, Continent; D014563:Urodynamics
chemical_list: D001672:Biocompatible Materials; D003432:Cross-Linking Reagents; C048470:glutaraldehyde-cross-linked collagen; D003094:Collagen